Colonoscopy Information For Patients Editorial Board Number: 0865/09 Issue Number: 02 Reviewed on: September 2009 Review Date: September 2011 1 Introduction Your doctor has decided that you need a test to examine the lining of your bowel. This test is called a Colonoscopy. This booklet has been prepared to help you understand this test. Please read it carefully. It includes answers to frequently asked questions. If there is anything that you do not understand or have any other questions, please ask. There is a telephone number provided on the back of this booklet. What is a Colonoscopy? A colonoscopy is a test performed to look at the lining of the colon (bowel). The bowel is a large tube with bends in it. A flexible tube, about as thick as your finger, will be passed into your back passage to look at the lining of your bowel. Some air will be put into your bowel during the examination, to make it easier to see the lining. Biopsies (samples) may be taken from your bowel lining during your test to help the doctor gain more information. The biopsies are not painful but will help the doctor plan the best treatment for you. Polyps (small growths that can develop on the lining of your bowel) can be removed and haemorrhoids (piles) can be treated at the same time. 2 Does my bowel need to be empty? - Yes You will have had some bowel preparation (a laxative - picolax) the day before your test, because it is important that your bowel is empty so that we can get a clear view of the lining of your bowel wall. It is important that you follow the instructions for taking your bowel preparation very carefully, as this will help the doctor to get a better view. How long will I be in hospital? Your length of stay on the unit will usually be between 2 and 4 hours, so it would be advisable to put aside a whole morning or afternoon. We will do our best to make you as comfortable as possible. What are the risks of Colonoscopy? Colonoscopy is a safe procedure, but there is a small risk of approximately 1 in a 1,000 of perforating the bowel during the test. If this happens it is sometimes necessary for you to have an operation to repair it. Bleeding may occur if polyps (small growths that can develop on the lining of your bowel) or haemorrhoids (piles) have been treated. Bleeding can occur in approximately (1:1000) patients. Bleeding is usually minimal but sometimes it can be more serious and would require you to stay in hospital overnight for observation. The doctor or nurse will discuss these risks and/or alternatives with you when you arrive at the unit. . What do I need to do to prepare for my test? Bowel Preparation • Take the bowel preparation as indicated in the instructions. Food and Drink • The day before the test follow the low fibre diet sheet. • Please avoid milk and other dairy products from after lunch on the day before the procedure and up until after the procedure has been completed. • Drink plenty of clear fluids, preferably water, throughout the time you are taking your bowel preparation and continue until bowel movements have stopped. • If you are also having a Gastroscopy on the same day as your Colonoscopy you need to stop drinking fluids 6 hours prior to you appointment time. Tablets and medications – Please read this carefully • Stop taking iron tablets 7 days before your test. • If you have a morning appointment, do not take your usual tablets/medicines. You will be able to take them when you return home after your test. 3 • If you have an afternoon appointment you can take your morning tablets/medicines as usual. • If you are taking warfarin/sinthrome, please contact the staff on the unit 5 days before your appointment day for advice. • If you are taking aspirin and/or clopidogrel, please contact the staff on the unit 7 to 10 days before your appointment day for advice. • The telephone number for advice is 0161 291 4892 Additional Preparation Advice • If you have Diabetes, and need advice regarding your test contact the staff on the unit. • Have you ever been contacted by the Public Health Department and been told you are potentially at risk of CJD (Creutzfeldt-Jakob Disease?). If yes, please contact the staff on the unit for advice before attending for your test. • You must have a responsible adult to take you home and stay with you for 24 hours after the test. If you do not arrange this your test may be cancelled. • The telephone number for advice is 0161 291 4892 What will happen before my Colonoscopy? • A nurse will ask you about your health, allergies and medications. Please bring a list of your medications with you. • You will have your blood pressure and pulse checked. If you are a Diabetic your blood sugar will also be checked. • You will have the opportunity to ask questions. • You will be asked by the nurse or doctor to give written consent for the test. • You will be asked to put on a gown. Please bring a small bag to put your belongings in. Your belongings will be safely put in a locker. Please do not bring any valuables with you as we cannot be responsible for any of your belongings whilst you are on the unit. • Please bring a dressing gown and slippers. How long does the Colonoscopy take? The test will usually take about 30 minutes. Will I be asleep? Not necessarily, but you will be relaxed. This is called conscious sedation. Conscious sedation is when the patient is relaxed and appears sedated, however 4 they remain able to respond to verbal questions or instructions. Hence the term “conscious sedation”- the patient is obviously sedated but is still “conscious” and responsive. (http://anesthesiologyinfo.com) What will happen during the test? You will lie down in a comfortable position on your left hand side. You will be given an injection to make you relaxed and sleepy into a vein in your hand or arm. Usually you are also given a painkiller (Pethidine or Fentanyl). Oxygen will be given to you through a tube which is placed in your nose. A small clip will be placed on one of your fingers or ear lobe to monitor your heart rate and oxygen levels. We will also provide ECG (heart rate) monitoring. A long flexible tube will then be passed into your back passage and air will be put gently into your bowel. You may feel that you want to go to the toilet, but because the bowel is empty there is no danger of this happening. You may pass small amounts of wind. Don’t be embarrassed, this is quite common. The doctor will be looking for any area that looks different to the rest of the bowel. If so, biopsies of the lining of the bowel can be taken and examined under a microscope. Sometimes polyps are found. Polyps are small growths that develop from the lining of the bowel. Some polyps need to be removed and it is usually possible to do this at the same time as your test. You must make the following arrangements because you will have had a sedative injection: You must: Have a responsible adult to take you home and stay with you for 24 hours after the test. You must not: • • • • • • Travel home on public transport Return to work for 24 hours after the test Drive or operate machinery for 24 hours after the test Be left alone or care for small children for 24 hours after the test Drink alcohol for 24 hours after the test. Sign any legal documents for 24 hours after the test. What happens after your test? Before you go home the doctor or nurse will talk to you about the test and about what happens next. You will be told about any biopsies (samples) that have been taken and when the results will be ready. All this information will be written down for you and any relevant health education information leaflets will be given to you. 5 We do our best to make your stay on the Endoscopy Unit as comfortable as possible. If you need any more information, or are worried about your test, please do not hesitate to contact the staff on the unit who will be pleased to help you. The Endoscopy Department Day Case Unit Wythenshawe Hospital Southmoor Road Wythenshawe Manchester M23 9LT Reference: (http://anesthesiologyinfo.com/2009 Telephone: 0161 291 4954 (Appointments) Telephone: 0161 291 4892 (Enquiries) 6